Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. May 27, 2025; 17(5): 104803
Published online May 27, 2025. doi: 10.4240/wjgs.v17.i5.104803
Evaluation of diagnostic laparoscopy results in Turkish patients with unexplained ascites
Ali R Caliskan, Mehmet A Erdogan, Adil Baskiran, Ibrahim H Ocal, Huseyin Kacmaz
Ali R Caliskan, Huseyin Kacmaz, Department of Gastroenterology, Faculty of Medicine, Adiyaman University, Adıyaman 02200, Türkiye
Mehmet A Erdogan, Department of Gastroenterology, Faculty of Medicine, Inonu University, Malatya 44000, Türkiye
Adil Baskiran, Surgery and Liver Transplant Institute, Faculty of Medicine, Inonu University, Malatya 44280, Türkiye
Ibrahim H Ocal, Department of General Surgery, Adiyaman Training and Research Hospital, Adıyaman 02000, Türkiye
Author contributions: Caliskan AR contributed to conceptualization, methodology, formal analysis, investigation, data curation, writing-original draft preparation, writing-review and editing, visualization, supervision, project administration, and funding acquisition; Caliskan AR, Kacmaz H, Erdogan MA, Baskıran A, Ocal HI contributed to software; Caliskan AR, Kacmaz H contributed to validation, resources; All authors have read and agreed to the published version of the manuscript.
Institutional review board statement: This study received ethical approval from the Non-Invasive Clinical Research Ethics Committee of the Inonu University Health Sciences on November 28, 2023 (Protocol No: 2023/5270).
Informed consent statement: Written informed consent was obtained from all participants before their inclusion in this study.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: Data related to the study can be shared if requested.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ali R Caliskan, MD, Associate Professor, Department of Gastroenterology, Faculty of Medicine, Adiyaman University, 1164. Street No:13, İpekli, Adıyaman 02200, Türkiye. acaliskan@adiyaman.edu.tr
Received: January 6, 2025
Revised: March 3, 2025
Accepted: March 17, 2025
Published online: May 27, 2025
Processing time: 141 Days and 9.4 Hours
Abstract
BACKGROUND

Diagnostic laparoscopy is a minimally invasive surgical method to diagnose intra-abdominal diseases.

AIM

To evaluate patients with unexplained ascites who could not be definitively diagnosed via advanced radiological and endoscopic methods and serological, cytological, and microbiological examinations and, therefore, underwent diagnostic laparoscopy.

METHODS

This retrospective analysis evaluated 82 patients who underwent diagnostic laparoscopy due to unexplained ascites. Patients’ medical records were obtained from the hospital database. Their age, sex, complaints at admission, laboratory results, radiological imaging results, diagnostic laparoscopy reports, and pathology reports were analyzed.

RESULTS

The serum-ascites albumin gradient was < 1.1 in 96.3% of the patients (n = 79). Among patients, 22 (26.8%) had benign diagnoses and 60 (73.2%) had malignant diagnoses. In addition, 55 (67.1%) were deceased, and the median follow-up time from diagnosis to death was four months. The overall follow-up time ranged from 1 to 142 months, with a median of 14 months. Patients’ diagnoses were significantly associated with their survival (P < 0.05, χ2 test). The mortality rate was 86.7% among patients with malignant diagnoses and 13.6% among patients with benign diagnoses.

CONCLUSION

Diagnostic laparoscopy is minimally invasive, has a low complication rate, and requires a short hospital stay. It can be safely performed to diagnose and treat ascites that remain unexplained after advanced radiological and endoscopic examinations.

Keywords: Diagnostic laparoscopy; Ascites; Peritoneal thickening; Peritoneal tuberculosis; Survival

Core Tip: Diagnostic laparoscopy is minimally invasive, has a low complication rate, and requires a short hospital stay. Diagnostic laparoscopy has an essential role in diagnosing patients with ascites whose cause cannot be identified with advanced imaging modalities and endoscopic examinations. Most non-cirrhotic ascites are malignant and have a poor prognosis. Satisfactory results can also be achieved in treating ascites due to tuberculosis.